How Is Sodium Bicarbonate Used to Treat Kidney Disease?

An antacid called sodium bicarbonate is used to treat metabolic acidosis in patients with kidney disease.

Kidney disease, commonly referred to as "chronic kidney disease" (CKD), is a disorder where the kidneys are injured and unable to adequately filter blood. Heart disease and elevated blood pressure are just two of the many consequences that can develop from chronic kidney disease (CKD).

Metabolic acidosis, a condition that happens when the body accumulates too much acid, is another frequent CKD consequence. The metabolic acidosis rate in CKD patients is approximately 15%.

Treatment options for metabolic acidosis may include prescription drugs, dietary modifications, and a substance known as "sodium bicarbonate."

What is sodium bicarbonate?

Baking soda, or sodium bicarbonate, is a common name for a medicine that lowers stomach acid. It is a member of the class of drugs known as antacids.

Sodium bicarbonate is frequently used as an over-the-counter (OTC) drug to treat indigestion, upset stomach, and sporadic heartburn.

Prescription medications containing sodium bicarbonate are also used to address conditions brought on by excess acid or potassium in the body. These illnesses could consist of:
  • metabolic acidosis
  • diabetic ketoacidosis
  • hyperkalemia
  • lactic acidosis
  • renal tubular acidosis
There are two forms of sodium bicarbonate available: a powder that dissolves in water and an oral tablet. It can also be administered via infusion or intravenous injection.

What is the purpose of using sodium bicarbonate to treat kidney disease?

When CKD patients experience metabolic acidosis, their kidneys are unable to eliminate enough acid from their bodies. An accumulation of acid upsets the body's normal acid-base (pH) equilibrium. Individuals with metabolic acidosis also have unusually low blood bicarbonate levels in addition to abnormally high acid levels.

A basic material called bicarbonate aids in the body's maintenance of a normal pH equilibrium.

Serum bicarbonate, or 22–29 millimoles per litre, is the normal blood bicarbonate level (mmol/L). Serum bicarbonate values below 22 mmol/L are consistently low in patients with metabolic acidosis.

To raise serum bicarbonate levels and support pH equilibrium, sodium bicarbonate, a base supplement, can be prescribed as medicine.

The following are the objectives of sodium bicarbonate treatment:
  • raise blood bicarbonate levels to a typical range.
  • control and cure acidity metabolism
  • avoid potential consequences and more severe metabolic acidosis.
  • slow the progression of CKD

Only take sodium bicarbonate as directed

If you have chronic kidney disease (CKD), you should only use sodium bicarbonate pills as directed by a physician. When taken as a medication, sodium bicarbonate needs to be dosed and monitored carefully.

What are the advantages of using sodium bicarbonate as a treatment for renal disease?

Using sodium bicarbonate to treat metabolic acidosis has the following advantages:
  • halting the progression of metabolic acidosis
  • slowing CKD progression
  • avoiding consequences of the advancement of CKD, like:
  • bone loss
  • muscle loss
  • malnutrition
  • insulin resistance
  • cardiovascular complications
  • improving nutritional status
According to a review published in 2021, sodium bicarbonate can considerably increase blood flow (vascular endothelial function) and slow the deterioration of kidney function in patients with chronic kidney disease (CKD).

A second trial from 2022 looked at treating metabolic acidosis and late-stage chronic kidney disease (CKD) patients with sodium bicarbonate therapy. The study discovered that nutritional indicators and metabolic acidosis in the blood were improved by therapy.

The Kidney Disease Improving Global Outcomes Guidelines for Chronic Kidney Disease (CKD) indicate that sodium bicarbonate is effective in raising serum bicarbonate levels, averting more severe acidosis, and averting potential consequences based on existing data.

The consequences of treating patients with CKD with sodium bicarbonate require further investigation.

Does using sodium bicarbonate to treat renal disease have any adverse effects?

Carbon dioxide (CO2) gas is produced when sodium bicarbonate is consumed, and this gas can cause common gastrointestinal side effects such burp and bloating.

Additional negative consequences could be:
  • unpleasant taste
  • increased need to urinate
  • nervousness or restlessness
  • headache
  • nausea or vomiting
Rarely, the use of sodium bicarbonate may result in a stomach rupture because of elevated intragastric pressure brought on by several variables, such as the presence of CO2 in the stomach together with food and liquids.

Because of this, avoid taking the entire daily dosage at once and only take sodium bicarbonate when you are empty-handed.

What are the dangers of using sodium bicarbonate as a therapy for renal disease?

An increased sodium intake is one possible danger associated with treatment with sodium bicarbonate.

Because sodium bicarbonate is a chemical molecule that combines sodium (salt) and bicarbonate, using it regularly might result in a significant increase in the amount of sodium consumed.

Elevated sodium levels in CKD patients may be linked to:
  • weight gain
  • swelling (edema)
  • hypertension
  • fluid retention
Increased salt consumption may also hinder the effectiveness of some CKD medications, such as renin-angiotensin-aldosterone system inhibitors, in slowing the advancement of renal disease.

Other possible side effects of sodium bicarbonate therapy include calcification of the kidney and arteries and higher-than-normal serum bicarbonate levels, which can cause health problems.

Generally safe and well-tolerated, sodium bicarbonate treatment is under close supervision from a medical practitioner.

What is the prognosis for sodium bicarbonate users with kidney disease?

The prognosis for CKD patients taking sodium bicarbonate relies on the degree of metabolic acidosis and the severity and stage of the disease.

Metabolic acidosis, when untreated, can cause severe side effects such as osteoporosis, progressive chronic kidney disease (CKD), muscle atrophy, and even death.

Medication like sodium bicarbonate and dietary modifications like consuming more fruits and vegetables high in alkali are effective therapies for metabolic acidosis. If you have kidney illness, these treatments might help you have a better prognosis.

Sodium bicarbonate has been demonstrated to be useful in controlling metabolic acidosis and averting potential problems, notwithstanding the need for additional research.


A prescription drug called sodium bicarbonate can be used to treat metabolic acidosis in patients with chronic kidney disease (CKD).

Sodium bicarbonate functions as an antacid, assisting the body in reducing acid excess and maintaining average serum bicarbonate levels, thus averting more severe metabolic acidosis and associated problems.

Sodium bicarbonate tablets should only be taken by CKD patients with a doctor's or other healthcare provider's prescription. Consult a physician to determine whether sodium bicarbonate treatment is appropriate for you.

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